A Novel Strategy for the Diagnosis of Pulmonary High-Grade Neuroendocrine Tumor.

Correctly diagnosing a histologic type of lung cancer is important for selecting the appropriate treatment because the aggressiveness, chemotherapy regimen, surgical approach, and prognosis vary significantly among histologic types. Pulmonary NETs, which are characterized by neuroendocrine morphologies, represent approximately 20% of all lung cancers. In particular, high-grade neuroendocrine tumors (small cell lung cancer and large cell neuroendocrine tumor) are highly proliferative cancers that have a poorer prognosis than other non-small cell lung cancers. The combination of hematoxylin and eosin staining, Ki-67, and immunostaining of classic neuroendocrine markers, such as chromogranin A, CD56, and synaptophysin, are normally used to diagnose high-grade neuroendocrine tumors; however, they are frequently heterogeneous. This article reviews the diagnostic methods of lung cancer diagnosis focused on immunostaining. In particular, we describe the usefulness of immunostaining by Stathmin-1, which is a cytosolic phosphoprotein and a key regulator of cell division due to its microtubule depolymerization in a phosphorylation-dependent manner, for the diagnosis of high-grade neuroendocrine tumors.

Checkpoint inhibitor is active against large cell neuroendocrine carcinoma with high tumor mutation burden.

BACKGROUND: Large cell neuroendocrine tumor (LCNEC) of the lung is a rare and aggressive tumor similar to small cell lung cancer (SCLC). Thus, it is often treated similarly to SCLC in the front-line setting with a platinum doublet. However, treatment for patients beyond the first line remains undefined. CASE PRESENTATION: We report the case of a patient with stage IB LCNEC (PD-L1 negative but positive for PD-L1 amplification and tumor mutation burden high) who progressed after adjuvant chemotherapy after surgery and subsequent therapy with an antibody drug conjugate targeting a neuroendocrine-specific cell surface marker but achieved a significant and durable response with pembrolizumab, a humanized IgG4 monoclonal anti-PD-1 antibody. CONCLUSIONS: Immunotherapy with checkpoint inhibitors is an effective treatment option for patients with metastatic LCNEC, even if PD-L1 expression is negative.

Tumor carcinoide pulmonar: A propósito de un caso / The Pulmonary Carcinoid Tumor. A Case Report

El Tumor Carcinoide es un tipo de tumor cancerígeno formado por células neuroendocrinas. Representa el 1 al 2% de todos los tumores. En el pasado, fueron agrupados en una categoría de neoplasias denominada adenomas bronquiales. Se los consideraba benignos o poco agresivos. Se clasifican según su ubicación en centrales y periféricos y de acuerdo a su histología, dependiendo del número de mitosis y la presencia o no de necrosis, en típicos y atípicos. Tienen una gran variedad de presentación clínica, con diferentes grados de agresividad y pronóstico. Generalmente su diagnóstico es tardío. Nuestro objetivo fue presentar un caso pediátrico de Tumor Carcinoide pulmonar, central y típico.

The pulmonary carcinoid tumor (CT) is a type of cancerous tumor composed of neuroendocrine cells. It represents 1 or 2% of all pulmonary tumors. In the past, these tumors were grouped into a category of neoplasias called bronchial adenomas. They are considered benign or little aggressive. They are classified in central and peripheral tumors depending on their location and in histologic typical and atypical tumors depending on the number of mitosis and the presence or absence of necrosis. They have a wide variety of clinical presentation, with different degrees of aggressiveness and prognosis. The diagnosis is usually late. Our purpose was to present a pediatric case of central and typical pulmonary carcinoid tumor.

Tumor carcinoide pulmonar: A propósito de un caso

El Tumor Carcinoide es un tipo de tumor cancerígeno formado por células neuroendocrinas. Representa el 1 al 2% de todos los tumores. En el pasado, fueron agrupados en una categoría de neoplasias denominada adenomas bronquiales. Se los consideraba benignos o poco agresivos. Se clasifican según su ubicación en centrales y periféricos y de acuerdo a su histología, dependiendo del número de mitosis y la presencia o no de necrosis, en típicos y atípicos. Tienen una gran variedad de presentación clínica, con diferentes grados de agresividad y pronóstico. Generalmente su diagnóstico es tardío. Nuestro objetivo fue presentar un caso pediátrico de Tumor Carcinoide pulmonar, central y típico.(AU)

The pulmonary carcinoid tumor (CT) is a type of cancerous tumor composed of neuroendocrine cells. It represents 1 or 2% of all pulmonary tumors. In the past, these tumors were grouped into a category of neoplasias called bronchial adenomas. They are considered benign or little aggressive. They are classified in central and peripheral tumors depending on their location and in histologic typical and atypical tumors depending on the number of mitosis and the presence or absence of necrosis. They have a wide variety of clinical presentation, with different degrees of aggressiveness and prognosis. The diagnosis is usually late. Our purpose was to present a pediatric case of central and typical pulmonary carcinoid tumor.(AU)

Mixed Large Cell Neuroendocrine Tumor and Adenocarcinoma of the Ovary / 대한산부인과학회지

Neuroendocrine tumor is a very heterogenous group arising from the neuroendocrine cells. Especially, large cell neuroendocrine tumor of the ovary is a extremely rare aggressive neoplasm, characteristically arising in association with a surface epithelial tumor. This report describes a mixed type of large cell neuroendocrine carcinoma and adenocarcinoma of the ovary. A 63-year old woman presented with abdominal distension and discomfort underwent staging laparotomy under the impression of ovarian cancer. The operation revealed an small ovarian mass with invasion of multiple region in peritoneal cavity by the tumor. Immunohistochemical and ultrastructural analysis confirmed the neuroendocrine nature of the tumor. The adenocarcinoma in this case is mixture of mucinous and endometrioid type. A diagnosis of stage IIIc mixed large cell neuroendocrine tumor and adenocarcinoma of the ovary was rendered. She is subsequently being treated with Paclitaxel and Carboplatin combination chemotherapy.